HomeMy WebLinkAbout113 YORKTOWN LN - Building Permits ADDRESS OF BUILDING) 113 YORKTOWN LN MT: � �
CITY OF COSTA MESA — BUILDING PERMIT
VA•NERS NAME IMTA CUMMINGS, ROBERT G TR PFRM NO. P 087544
ADDRES113 YORKTOWN LN
COSTA MESA,CA 92626 PERMIT NO: P 087544 PLAN CHECK NO: N GOVT: N SUPP: N
mplAWING ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
ARCXRECT OR EN(fNEER: UC.NO.:
JOB DESCRIPTION : INSTALL WATER HEATER SQ FT:
ARCH.OR DRi:S ADDRESS: BHT:
mxmACTORSNAI� CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 /
cGUnUCTRs MAILING CLAIM
PLUMBING ( 714 ) 895-1246
11612 KNOTT ST COMMENTS : NO OTHER WORK ASSOCIATED WITH THIS PERMIT
ADDREss: GARDEN GROVE CA sec."°.: 707775 ********stat**************+nit***x-rtit**truer************at*+t+ *****it*****i(at*+i**3t****it**+t
92841 Dna' 17 Z ON ING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby term under penalty of°erjuy t at I am licensed under PreMa"of Cheater 9 S E T B A C K S
(commencing with Section 7000)of Dhason 3 of the Business and Professions Code,and my license S in full lace end effect.
CfTY UC.NO.: UC.CLASS: UC.NO.:
O5 GG C 36 77 EXP: 02/9 MAIN BUILDING ACCESSORY BUILDING
Done: / Cd Contractor FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
OWNER BUIL DE LARATION:I hereby affirm under penalty d per ,I am exempt from the Contractors License Law to the LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a pert to construct alter.improve.
demolbh,or recta any stkm/pawcture,prior to its kmalso requires the applicant for suchpenmf to fib t
a signed at he or she PARKING REQ: PROV: PARCEL: 41916243 ZNE: REF NO:
' is licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commerwrg with Section 7000)of Division 3 of the PLANNING NOTES>
Business and Professions Cede]of that he or she Is exempt therefrom and the bass for the alleged exemption.My violation Of Section
7031.5 by any applicant for a peanut artistes the applicant to a civil penalty of net more then love hundred dollars 155001). >
❑ lasownerdlhe property or my employees with wapvmtheisole compensation,Wldo the work.end the studurobnd intendnd *******************************************************************************
es offend fur gale Business end Code:The Contractoror s License Law does napply entwnerof properly D E V E L O P M E N T SERVICES / REQUIREMENTS
ho Cfwbolds improves thereon,and who does such work himself or horsed or through he or her own employees,provided that such
improvements we not intended or offered for sale.f,however,the building or improvement is soil wi
Mdsothin one year of completion,the / J. DATE:
ownerDer will o have the burden proving heshe not bulb d sale). ZONING APPROVED BY or improve for purpose
❑ I,as owner of the property.am exclusively contracting with licensed connecters to construct the project(Section 7044,Business and
Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY i " ? DATE:
contracts to such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ I am exempt under Section: B.a P.C.,for this reason: APPLICATION ISSUED BY: /01DATE:
Dale: Owner. ************************************************aF******************************
I do hereby certify that I ane aware of and understand the requirements of California Health and Solely Code Sections 25505,25533,and LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N
25531,end that I or any haunt buildup occupant will/wil nor(dreb one)need to comply wah said state cedes end the requirements to
a permit tomsWmionor modification from is AirMFICranagetrient District Resbamblmmtxtion aspirations an exempt from tea BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
pr°"er°n PERMIT 11 . 00
Dale: Applicant: 25% SM I P/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm wider penalty of perjury one d the following dedambm: PLAN
o l have and MI maintain acMfcated consent toseuunure for workers'compensanasci provided ed for by Sion 37U3d the Labor ISSUE FEE 22 . 00
Code.fothe pedormanceof the wokfor whichthipernsbissued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ I have end MN maintain workers'compensation insurenos,as required by Section 3700 of the Labor Code,for the performanos of the TOTALS----> 11 . 00 22 . 00 0 . 00 33 . 00 33 . 00 . 00
X work for which this permit is issued.My workers'compensation insurance carrier end policy number are:
Gamier COLDEN EACLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 33 . 00 OVER/SHORT: . 00
PolicyNumber. NUC 17934 /02 09/01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
This seniors need not be compered l the pant is tor one hundred dollars($1001a ) 33 . 00
❑ 1 certify that in the•.r1• . • the work for which this pert is issued,I sal not employ any person In any manner so se to
.. .. ... t. v. ....,:.ion laws d CaNania.and agree than"I should become abject to the workers•
compernm , .the .iom�•. y..d the Lebo Code.l sera lath wWone. *******************************************************************************
Date. 7 i / Appkam: /// I N D I V I D U A L F E E B R E A K D O W N
Warning:Fatu. •see wotion'conpensadon coverage Is unlawful,and shall subject anemployr to admlmlprmldr end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fins up to one hmrdied thousand dollars($104000),In addition to the soil of conprmetbn danpq as Provided for In
Section 3706 of the Labor Cods,interest and attorneys feu.
CONSTRUCTION LENDING AGENCY:I hereby affirm under penaltyof perjury that there is a construction lending agency for thePLU 1 WATER HEATER AND/OR VENT 11 . 00 11 . 00
performance of the work for which the permit is issued(Section 3097,Cb.C). END OF FEES
LENDER'S NAME:
LENDER'S ADDRESS: taiSt"
II have read this applicationthat and mate at the above information bne s
co .I agree to comply with ay with aordinances
ordices
and nd state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property
for inspection purposes. ir h r
RON No . —M rthtR . (,f Z fr:no ' '•S
Prim
Data: I Cil •✓ res l E-C: }' .... ...
Signature d Owner/AgmUApplcant'Lontrada 1 :c.a-rC7, L;e,_„:j?,
(5151-46.WP) White-Building A Welly Green-Re:Ca any-Appfunt;Pink-Revenue:Goldenrod-Assesses /
' A
CONSTRUCTION AND PLANNING POOL . 0PA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. 'Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64, Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POO USPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning i FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace • APPROVALS - Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test - 72. Underground Flush
24. Roof Framing 73.,Undergrnd.Storage Tank OGas 0 Oil
25. Roof Sheathing • - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - • 75. Dry Chemical • • • •
27. Frame and Flashing . • - - 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM-FINAL
29. Insulation78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat. .79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Anal Electric . . Notes:
34. Final Heating& Air Conditioning •
.
35. Final Gas Pipe-Test ' -
36. Hood or Canopy -
37. Final Factory Fireplace
38. Final Plumbing 1 -
(g757
39. Water Service-Final •
40. Gas Service-Final
41. Solar Domestic-Final •
•
42. Backflow Preventer •
43. Backflow Irrigation
- 44. Landscape.Irrigation System
, 45. Sound Attenuation •
I .• '
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING •
•
' 48. FINAL PLANNING
' 49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
I P'rOJECL' jRESS: 113 YORKTOWN LN
, -(NAME: CUMMINGS UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 069482
'.AooREss: 10 FOREST ROBERT G TR PERMIT NO; B 069482 PLAN CHECK NO: N GOVT; N SUPP; N
IRVINE,CA 92715
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; T/O RESTH 6 REROOF W/COPM & HOT MOP SQ FT; 2, 508
ADDRESS: UNIT:
CLIPLe
CLAIM VALUE: 2, 508 . 00 CALC-VALUE: 2, 508 . 00 GROUP OCC; R-1 /
PERMITTEE: STOUT ROOFING, INC. ( 310 ) 923-6775
ADDRESS: 9700 WASBURN RD COMMENTS : REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REQUIRED
DOWNEY CA 90241 *******************************+t*********+r*****+t*****+t+a**********************ir+t
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQU IR EMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACK S
cm lc.: 05977 STATE LIC.: 402536 CLASS: C-39 EXP; 10/95
D e. I 0Iag Oa
Signature: MAIN BUILDING ACCESSORY BUILDING
ORKERS'COMPEN ATION DECLARATION: I hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation Inurare or a certified copy thereof(Section 3800. Lab.C. LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PDuuNo.: 827699 EXP.DATE: 5/19/95
=NARY: AIG PARKING REQ• PROV; PARCEL; 41916243 ZNE: REF NO;
❑ Certified copy is hereby furnished. LX CertPLANNING NOTES>
ified copy is filed with the city Building Division.
/� IA) >
Dale: Io(�,J,�{yI LAgplicantaL ********************************************************************1F**********
/ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V F L O P M E N T S E R V I C E S R E Q U I R E M E N T S
I certify that in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY
DATE;
Date: Signature: BUILDING APPROVED BY ;
NOTICE:N,after making this declaration,you should become subjectmithe Workers' rempensation provisions of the Labor DATE
Code,you must NG G comply I withe such firm that this permit shall beendingdeemed revoked. p fl�
CONSTRUCTION LENDING AGENCY: hereby Cl.irm that there is a construction lending agency for the pedormance of the work for APPLICATION ISSUED BY; DATE: •O 2 /
which this permit is issued(Section 3097.Civ.C ********************************* ***************************** ** ***Bf ***
LENDER: *********************************************************************i!!*********
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 . 50
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 , 00 0 . 00 54 , 50 54 . 50 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: . 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 , 00
rj 0
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Dale- Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 2, 508 , 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and heresy authorize representatives of this city to enter upon the above-mentioned
property for inspection pure ses.
' 9 ,/ 01 40170459-00170480 TOT 54.50
te:M019 ' Signature: 4-l/ �— DATE; 10/28/94 TIME: 12:08
7. r.s
veLicense or/Social Security n: .
'46 White—Building:Green—Cade Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
&PPROVALS
ONSTRUCTION AND PLANNING POOL 'A
Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement
3.-fiectrical Condoit U$ility Undrgrnd. 54. Forms
4:I-Electrical Condu€� pdrgrnd. 55. Electrical Bonding
•' 5.r5teel Reinforcement 56. Rough Plumbing & Pressure Test
6:"Electrical UFER,Drnd. 57. APPROVAL TO COVER-GUNITE
j. Footings _ 58. Electrical Conduit-Undrgrnd.
pt. Foundation ",r, rt) . . 59. Gas Pipe, 0 Undrgrnd.,Test
- 9. Water Pipe-Undcgrnd. 60. Backwash Lines, P-Trap. 0 Unilrgrnd.
1Q. Structural Floor.System `, 61. APPROVAL TO DECK
ii. Propert Sewer Line & House Connection
y 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
.. CL. O
13. Roof Drains :, 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final
1
15. Rough Electrical-Conduit,,, 66. Solar System-Final
16. Rough Electric Wiring s. 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20;tiough Factofy Fireplace I ni -- •' it. O IAPPReVAt&DC:Per/ttit # r r.
!. ., _ 114 itj, .,t.-V-- - I
21._Duc�s,intc ctuge' -' _ .
r.. � : i70. Uhdergi'4l'n. Hydro f Vt
22: Ducts, Vent hating. - ':.S * _ ti* I. 171. Producf PIping Flues D'Oil
23. Gas Pi e'Rou h 8 -Test '
•. P 7j ; o a n*, ,Th * 72. Undergro incl Flustr •
24.,Roof Framing ;j* -•t-, . : 3 c' + x ".:.73.rUndergrnd;Storagrank 0Gas 0 Oil
25. Roof Sheathing re,„ it -. ?B1 uj%% 74 2Overhead Hydro ''`' I
26.-.T-8ar Ceiling (Structural) & R+lonocoat . -i. PI"-I fr • 75:-Ory Chemical - 2 -4 1:
27._Frame and Flashings `- _r Y, r ; 76.'15NStany:i e ,-,,ii ,'. " r 1;
- Lathing & Sidings;, ..1 {a: a; " 77."FIXED SYSTEM,FINAL'. ^'
29. Insulatiop '- 'I 17.! " •' ;, 1 " 78z. FIRE PREY- FINAL- r,
:30. Dry*vall<Nailiig m u � .• H.EALTHIDEPTt R-EQUIREMENT
31. Plaster Brown Coat _, + I Ir ty79. (FINAL It $P CTI9N i - _ 1
I I C ., I .-i - rt t Tl __moi__.r c-. _�
:32.--Electncal•Power teaterr . .;Final;t 1$1 ;.rr O- rFOOD CERTIFICATE ISSUED
1-1
33."-Final Eleletrid - I - Cr- I 1 r .r "zNot s: 7 a _ '
r
r34. final Heating& gr;Conoitioning_ T _
35.hFinahGas:Pipo-Tell* •'r i* ' a. -
s36.'Hoodor`Canopyz. .,;: s ;, I 1 '* > r o T
'-37.C.FineFaaory Fireplace._ E.^' ': # -r I I !$
-38. FinaJ,PIumbing r i- � ; r r 1 I l+ _ . .
39. Water Serice-final
1: -
evn i r 1'. ' )
J.
'40. Gas Service-Fnal`r. `-'. I I * *
+41. Solar Domestic-Final _. • •• ,D 1 I h
, -,, I i. r --i - ..
--42, -Backflow Preventer" ' r;; , I h" .
43. Backflow Irrigation* o,- .-' ' - - ` -
. •
44. LandscappIr gationSystem,-om;. .. , rr1 .> - v _ -)
45.Sound Attenuation< =n P-1 ,. ?: f-.> • 0 - R,< Jr
•'1 s Pi .. .. ..e . .. .
,-46.-Nandicap Reg¢latross7 ,, y
.47. -FINAL STRUCTttRE & BUItDING //JJ p p 6441:� '-.i un::
48. FINAL PLANNING; 1 '. -, - T; I ( �" .r -ti s - n
49. Eleciric Release to Edison I r. 1 I . . � - .ti
m -
%0 Gas Release to Southern Califorpia,Gas Co , I - E; ,, -2 ,,� •
51. CERTIFICATE OF bCCUPANCY- _ - .
No. Date
•
OWNER SAN VISTA Building Co. DATE OCT 3 0 1963
JOB ADDRESS 113 Yorktown Lane BUILDING PERMIT NO. 20683
GENERAL CONTRACTOR ,e,n Vista Building Co. VALUE $ 11�,E35.00
AP No. LOT 293 TRACT 3.60 FIRE ZONE DESCRIPTION OF WORK Rea.w/att.gar
D PECTIONS Sigpature DATE GROUP y84 TYPE V ZONE R-3SUBCONTRACTOR PERMITS ISSUED
Gas I ;-/j- �! DATE NUMBER
Water //-4,3
Rough Com. Refrig. 0 Air Cond. 0 ` }
Rough Heating ag,t 2-ft 4_./e,4Z%. e, ,yt�-�k.I cam--- \`1--0, t ,4115---•'
Rough Plumbing /7-.0 3"lj‘e �v-. /i- /-L'a 3772-2 _
Miscellaneous
Prop. Swr. Line ❑ House Con. iG' St. Swr. 0 -. . i -,-n e,r� . ,_.. NOV 1 3 1963 ("' SN'
S rinkling System J• ; -
Construction Pole /ill.
Underground C❑ Power i0 "li
Rough Wiring - cam --S�, 'd " // a './<.. /,.e 2 -G-GV .7477,/
Trenches 0 Forms LI Steel Reinf. 0 /L ' O — - ,
Floor SystemMI
Bond Beam 0 Steel Reinforce 0 II' 'mft"
Sheathing N9 e .2- S /G rf/ !1; ble
Frame and Flashing �/- c .3 / 7/ c.cf 'Y /'"
Lathing— In Out 1_r „ 0.- /•J a S/ .0 I'
Plaster, brown coat c. C/3 4 S'` A( i
B '. 0 Air Con. ❑ Final / V 1
L. ag, Final -/ _ i31 CH v
Numbing Fixtures,,( Final
(, yj�iJ
Final Gas Test f�'-{4 ljf' csy'
Electric Fixtures, Final - _ .r !f� ��
""'�
7�i/er leo
Building, Final /_ . 3!_
OCCUPANCY '
'Film, ARLRMILR(LC_A P Hl J1 Mt lir CDM19 Al DCAT ITDCLTCLPPC
20683 FEE RECEIVED
•• COSTA MESA BUILDING-SAFETY DEPARTMENT SE? 2 6 1963
P.O.BOX 317 COSTA MESA.CALIFORNIA FINANCE DEPT.
t (�,�y TIF e Mice
For Applicant to Fill In Completely APPLICATION F6RTPEIM
TYPE OR PRINT Lot 293 BUILDING
For Office Use Only
BUILDING
ADDRESS 113 Yorktown Lane
RECEIPT NO. PEHB is
COSTA MESA. CALIFORNIA •(L-�(��.J1��1[oJ�
RECEIVZD BY DATE RECEIVED DATE ISSUED
OWNER San Vista Building Co. �.? 25t43. OCT 3 �n-/IgRl
MAIL 1166 E. 58th Street ADDRESS JA,
ADDRESSFIRE
TEL. ZONE TYPE V GROUP p
CITY Los Angeles 11 TEL AD 37187 L _y
ARCHITECT TEL AAP'PROVED DATE �/
OR ENGINEER Raymond Levanas ND. OR 37010A
ESS 3432 Via Oporto, Newport Beach AS ONING �, < 4 �,
20 �. NO. SE Fyyy111PPP...ByByBy���:::✓���. �I
CONTRACTOR San Vista Building Co.
Pune uLI ,
LEGAL ,3
ADDRESS L166 E. 58th St. DESCRIPTION/ l
Tract 5160 - Lot 293 '
CITY Los Angeles 11 A.P.I/c 3 7 3 'f
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
SATE TEL.
LIIC..NO. 192782 NO. AD 37187 90'TO SIDE ft REAR P.L.
EAVES
SIZE 20 X 70 NO.OF CLOGS. O
NOW ON LOT ALLOWED (U.B.C.REQUIREMENT)
OF L
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. None
(FROM C/L STREET/
SETBACK LINE FROM 131 6 11011 FRONT RT.
CENTER OF STREET REAR YARD
0 I RIGHT 0 R.SIDE Fr
SIDE YARD LEFT 1
DESCRIPTION OF WORK L.SID Fr.
NEW I X ALTERATION_ ADDITION REAR FT. Fr.
DISTANCE BET. BET.MAIN&
RE,. A MOVING pOEMOL($H MAIN BLDGS. ACCESS.BLDGS.
BUILDING 20 x 32 "4' 5 Lan ��ff..77 2 VAR.# DATE
SIZE ROOMS STORIES C. APPROVED
EXTERIOR WALK BOOR AP R O1 ,s, /e_5
COVERING JClNDW I COVERING Shingle AT A R�A,IA�F DATE
USE OF BUILDING AND WORK TO BE PERFORMED - lVl_7���
Residence and Carport ,% t r
AI
J. i36 . IVol-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHO ' UNDER VALUATION IS FOR THE 8
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION m
BUILDING CONSTRI 'N. (J N
SIGNATURE OF S' VIS6A BUILDING CO. PERMIT FEE $ /
PERMITTEF t_-.2--'
, cIJ/ "G
I.
AUTHORIZED AG 'T
:IDe9 N. $t8 8 f ��� PMN CHECK S / I
V TOTAL FEE 5
7)